Severe obesity increases risk of graft loss in pediatric heart transplantation

Figures

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  Worse heart transplant survival in children with severe obesity.

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  Figure 1. The frequency analysis of overweight, obesity, and severe obesity in children from the UNOS database who underwent heart transplantation from January 1, 2010, to December 30, 2023. UNOS, United Network for Organ Sharing.

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  Figure 2. Reduced survival after pediatric heart transplantation (age 8-18 years) from the UNOS dataset severe obesity versus control (those without severe obesity) at 10-year (45%; 95% CI. 32%-57% vs 64%; 95% CI, 61%-67%, P = .01). UNOS, United Network for Organ Sharing.

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  Figure 3. Reduced 5-year survival in heart transplant recipients with obesity when with regards to age (A), gender (B), and diagnosis (C). A, Comparison of severely obese (O) versus control (C) broken down by age groups of those younger than 11 years of age (<11) (82%; 95% CI, 71%-92% vs 87%; 95% CI, 85%-89%), aged 11 to 15 years (11-15) (82%; 95% CI, 73% - 91%) vs 84%; 95% CI, 82%-86%), and older than 15 years of age (>15) (59%; 95% CI, 41%-77%) versus 78%; 95% CI, 74%-82%), P = .02. B, Comparison of severely obese male (M) (79%; 95% CI, 70%-88% vs 84%; 95% CI, 82%-86%) and female (F) (77%; 95% CI, 66%-88% vs 82%; 95% CI, 81%-84%), P = .04. C, Comparison of those with severe obesity and congenital heart disease (CHD) (72%; 95% CI, 57%-87% vs 79%; 95% CI, 77%-81%) compared with cardiomyopathy (CMP) (79%; 95% CI, 71%-87% vs 85%; 95% CI, 83%-87%), P = .01. CI, Confidence interval.

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  Figure E1. Waitlist survival for severely obese children versus control (88%; 95% CI, 85%-91% vs 88%; 95% CI, 87%-89%), P = .89. CI, Confidence interval; BMI, body mass index.

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  Figure E2. Survival breakdown on the basis of severity of Centers for Disease Control and Prevention classification of body mass index: normal [83%; 95% CI, 82% - 84%)], overweight (83%; 95% CI, 80%-86%), obese (80%; 95% CI, 76%-84%), and severely obese (78%; 95% CI, 72%-84%). CI, Confidence interval.

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  Figure E3. Heat transplant survival for severely obese children versus control with regards to race: White (W) (78%; 95% CI, 67%-89% vs 84%; 95% CI, 82%-86%), Black (B) (77%; 95% CI, 66%-88% vs 79%; 95% CI, 75%-83%), and other (O) (78%; 95% CI, 65%-91% vs 85%; 95% CI, 83%-87%), P = .11. CI, Confidence interval.